• Samuel K Cho, John Caridi, Jun S Kim, Zoe B Cheung, Anup Gandhi, and Jason Inzana.
• Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: samuel.cho@mountsinai.org.
• World Neurosurg. 2018 Dec 1; 120: e1136-e1142.

ObjectiveTo investigate the effect of sublaminar polyester tension bands on the biomechanics of the motion segments proximal to a long fusion construct.MethodsThis was a human cadaveric biomechanical study. Pure moments of 4 Nm and 8 Nm were applied to the native spine and the instrumented spine, respectively (n = 8). The test conditions included native spine (T7-L2), fused (T10-L2), fused + bilateral tethers tensioned to 250 N at T9-T10 (tethers 250 N), fused + tethers tensioned to 350 N (tethers 350 N), fused (T11-L2) + tethers tensioned to 250 N at T9-T10 and 350 N at T10-T11 (2-level tethers), fused (T10-L2) + hand-tied suture loop through the spinous processes at T9-T10 (suture loop), and fused (T10-L2) with the T9-T10 interspinous and supraspinous ligaments cut (cut ISL/SSL).ResultsThe flexion range of motion (ROM) at T9-T10 of the fused spine, loaded at 8 Nm, increased to 162% of the native spine loaded at 4 Nm. The average flexion ROM at T9-T10 for tethers 250 N, tethers 350 N, 2-level tethers, suture loop, and cut ISL/SSL were 85% (P < 0.0001), 70% (P < 0.0001), 93% (P < 0.0001), 141% (P = 0.13), and 177% (P = 0.66) of the native spine at 4 Nm, respectively (P values vs. fused).ConclusionsSublaminar polyester bands can modulate the biomechanical flexion ROM as a function of the band pretension and provide a more consistent and tunable technique than hand-tying a suture loop between the spinous processes.Copyright © 2018 Elsevier Inc. All rights reserved.

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